| Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
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| 10.01.01 |
Non-steroidal anti-inflammatory drugs |
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Celecoxib
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 Restricted
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Provider notes - NMUH:
- RFL:
- For Rheumatology use only
- RNOH:
- UCLH:
- WH:
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Diclofenac sodium
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Restricted
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Provider notes
- NMUH:
- See MHRA Drug Safety Update
- RFL:
- Restricted to Rheumatology, Obstetricians / Gynaecology and Paediatrics (suppositories or injection)
- Injection, Suppositories 12.5mg/25mg/100mg, EC tablets 25mg/50mg
- RNOH:
- Restricted: Diclofenac treatment should only be initiated after careful consideration for patients with significant risk factors for cardiovascular events (eg, hypertension, hyperlipidaemia, diabetes mellitus, smoking).
- UCLH:
- WH:
- See MHRA Drug Safety Update
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Diclofenac sodium + Misoprostol
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Restricted
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Provider notes - NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
- Must not be given to women of child-bearing potential
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Diclofenac sodium modified release
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Restricted
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Provider notes
- NMUH:
- Non-formulary
- Check MHRA Drug Safety Updates
- RFL:
- Restricted to only Rheumatology and Obs / Gynae
- M/R tablets 75mg and 100mg available
- RNOH:
- UCLH:
- WH:
- See MHRA Drug Safety Update
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Etodolac
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Restricted
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Provider notes - NMUH:
- Restricted to use by Rheumatology Consultants only
- RFL:
- Restricted to use by Rheumatology only
- RNOH:
- UCLH:
- WH:
- Restricted to Rheumatology only
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Etodolac modified release
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Restricted
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Provider notes
- NMUH:
- Restricted to use by Rheumatology Consultants only
- RFL:
- Restricted to use by Rheumatology only
- RNOH:
- UCLH:
- WH:
- Restricted to Rheumatology only
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Etoricoxib
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Formulary
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Provider notes
- NMUH:
- Non-formulary
- Check MHRA Drug Safety Updates
- RFL:
- Restricted to use in Rheumatology indications only in patients with low cardiovascular risk after two standard non-selective, non-steroidal anti-inflammatory drug (NSAID; for example, ibuprofen and naproxen), has failed to achieve symptom relief, as per NCL JFC position statement February 2021
- RNOH:
- UCLH:
- WH:
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Ibuprofen immediate release
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Formulary
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Provider notes - NMUH:
- See MHRA Drug Safety Update
- RFL:
- RNOH:
- UCLH:
- WH:
- Intravenous injection restricted to Consultant level
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Indometacin immediate release caps
(Analgesic)
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Formulary
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Provider notes
- NMUH:
- Access Trust guideline via intranet
- RFL:
- RNOH:
- UCLH:
- WH:
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Indometacin modified release caps
(Analgesic)
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Restricted
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Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
- Restricted to Rheumatology only
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Mefenamic acid
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Restricted
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Provider notes
- NMUH:
- Non-formulary
- See link below
- RFL:
- Restricted to Gynaecology
- RNOH:
- UCLH:
- WH:
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 NMUH: Treatment Options for Primary Dysmenorrhoea and Menorrhagia
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Meloxicam
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Restricted
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Provider notes - NMUH:
- RFL:
- Restricted to use by Rheumatology only
- RNOH:
- UCLH:
- WH:
- Restricted to Rheumatology only
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Naproxen
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Formulary
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Provider notes
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Piroxicam
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Formulary
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Provider notes - NMUH:
- RFL:
- Restricted to Rheumatology only
- 10mg capsules available.
- RNOH:
- UCLH:
- WH:
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Sulindac
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Restricted
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Approved as first line treatment for oestrogen receptor-negative, desmoid-type fibromatosis for patients with slowly progressive, unresectable disease. Specialist initiation only (July 2014) Provider notes
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Acemetacin
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Restricted
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Provider notes - NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
- Restricted to Rheumatology only.
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| 10.01.01 |
Aspirin |
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| .... |
| Non Formulary Items |
Aceclofenac
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Non Formulary
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Azapropazone
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Non Formulary
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Dexibuprofen
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Non Formulary
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Dexketoprofen
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Non Formulary
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Diclofenac potassium
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Non Formulary
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Fenoprofen
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Non Formulary
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Flurbiprofen tablets
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Non Formulary
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Ibuprofen modified release
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Non Formulary
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Ketoprofen
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Non Formulary
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Ketoprofen + Omeprazole
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Non Formulary
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Ketoprofen modified release
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Non Formulary
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Nabumetone
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Non Formulary
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Naproxen + Esomeprazole
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Non Formulary
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Naproxen + Misoprostol
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Non Formulary
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Tenoxicam
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Non Formulary
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Tiaprofenic acid
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Non Formulary
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Key |
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Traffic Light Status Information
| Status |
Description |
 
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Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.
Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.
Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity. |
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Medicines which should normally be prescribed by specialists only (hospital only).
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf |
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Medicines not recommended for routine use in primary or secondary care.
Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data. |
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